Chemoradiotherapy Versus Chemotherapy Alone for Advanced Esophageal Squamous Cell Carcinoma: The Role of Definitive Radiotherapy for Primary Tumor in the Metastatic Setting

Li, Liqing; Fu, Qin; Zhao, Weidong; Wang, Yudan; Meng, Wan-Wan; Su, Ting-Shi

doi:10.3389/fonc.2022.824206

Cited by 12 publications

(6 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The role of radical radiotherapy in patients with advanced oesophageal cancer has been reported, but most studies have not conducted subgroup analyses of patients with OM [18][19][20] . Iwatsuki et al [21] retrospectively analysed 85 patients with oesophageal cancer and oesophagogastric junction adenocarcinoma (OGJA) who received multidisciplinary comprehensive treatment and had ≤ 5 metastases involving only a single organ; the 5-year postoperative OS rate for the whole group was 25%, and isolated metastases, systemic chemotherapy followed by supplemental local radiotherapy, and earlier N staging were associated with a better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Effects of different treatments on the prognosis of patients with single-organ oligometastasis of oesophageal cancer after surgery--a retrospective cohort study

Xu,

Song,

Wen

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective To investigate the influences of clinicopathological factors on the prognosis of patients with single-organ oligometastasis of oesophageal cancer (soOMEC) after surgery and to establish prognostic nomograms. Methods This was a retrospective analysis of 144 patients with soOMEC after surgery in a single centre who met the inclusion criteria. First, Cox univariate and multivariate models were used to analyse (SPSS 25.0 statistical software) the characteristics of patients, and independent prognostic factors for postoperative overall survival (OS) and OS after oligometastasis (OM-OS) were determined. Prognosis was analysed using R language software, nomograms were created based on the Cox multivariate analysis results, a bootstrap method (b = 200) was used for internal validation, and receiver operating characteristic (ROC) and calibration curves were used to validate the models. Results From January 2014 to December 2017, a total of 1595 patients with oesophageal cancer received R0 resection. As of the end of the follow-up period, 144 patients had single-organ oligometastasis (soOM). The median time to oligometastasis (TTO) in the whole group of patients was 14.2 months, and the 1-, 3-, and 5-year OS rates were 75.7%, 28.2%, and 13.3%, respectively. The median OS was 25.0 months (95% confidence interval (CI): 21.8–28.2); the 1-, 2-, and 3-year OS rates after distant metastasis (DM-OS) were 25.5%, 13.3%, and 7.2%, respectively, and the median DM-OS was 5.5 months (95% CI: 3.9–7.1). The Cox multivariate analysis results showed that three indicators, i.e., TNM stage (hazard ratio (HR) = 2.192, 95% CI: 1.441–3.336, P = 0.000), TTO (HR = 0.119, 95% CI: 0.073–0.194, P = 0.000), and treatment after DM (HR = 0.784, 95% CI: 0.970 − 0.025, P = 0.025) were independent prognostic factors affecting the OS of patients; TTO (HR = 0.669, 95% CI: 0.455–0.984, P = 0.041) and treatment after DM (HR = 0.713, 95% CI: 0.559–0.910, P = 0.007) were independent prognostic factors affecting the DM-OS of patients. Using the Cox multivariate analysis results, prediction nomograms for total OS and DM-OS of patients were established. In the validation of the nomogram models, the areas under the curve (AUCs) for the 1-, 3-, and 5-year total OS were 0.930, 0.927, and 0.928 in the training set and 0.705, 0.856, and 1 in the validation set, respectively; the AUCs for the 1-, 2-, and 3-year DM-OS were 0.904, 0.923, and 0.908 in the training set and 0.928, 0.842, and 0.895 in the validation set, respectively. The results showed that the two models have strong discriminative ability and good clinical promotion and application value. Conclusions Aggressive local therapy combined with systemic chemotherapy can benefit patients with soOMEC after surgery, and for patients with OM appearing at 1 year after surgery, aggressive radiotherapy or combined chemotherapy is expected to improve the prognosis and prolong OS. The nomogram models developed in this study are effective clinical tools for predicting the prognosis of such patients and can be of great value in predicting the prognosis of and determining the treatments for patients and can guide the individualised treatment of such patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of different treatments on the prognosis of patients with single-organ oligometastasis of oesophageal cancer after surgery--a retrospective cohort study

Xu,

Song,

Wen

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The use of palliative local therapeutic interventions might be an optimal alternative treatment for symptom relief. It has been found concurrent chemoradiotherapy improved the prognosis of patients with metastatic esophageal cancer compared with radiotherapy alone [29][30][31][32][33][34][35][36] . In addition, the radiotherapy dose is a factor affecting the prognosis of patients with metastatic esophageal cancer [31] .…”

Section: Discussionmentioning

confidence: 99%

Multimodal radiotherapy in recurrent refractory metastatic esophageal cancer

Luo

2023

Preprint

View full text Add to dashboard Cite

Background To explore the efficacy and toxicity of multimodal radical radiotherapy and systematic therapy in refractory recurrent metastatic esophageal cancer. Patient and Methods A 57-year-old man with locally advanced esophageal squamous cell carcinoma (ESCC) presented with supraclavicular lymph nodes and bone metastases six years after radical resection and adjuvant chemotherapy. After multiline systemic therapy, the tumor progressed with involvement of lymph nodes in the left neck, supraclavicular, subclavian, and axillary regions, as well as the C6 vertebral bone. The patient exhibited Horner’s syndrome on the left side as well as brachial plexus nerve injury with serious pain. Adaptive intensity-modulate radiotherapy (IMRT) combined with high-dose brachy radiotherapy (BRT), and stereotactic radiotherapy (SBRT) was applied to control local foci, together with systemic treatment using target and immunotherapy as maintenance. Results The patient showed complete remission (CR) of symptoms and signs, including the complete disappearance of the left neck metastatic lymph nodes, CR of the left upper-neck metastatic lymph nodes, and satisfactory local control of bone metastases. The progression-free survival (PFS) was more than 20 months, with CR of pulmonary metastases, satisfactory control of hepatic metastases, and PFS for lung and liver foci of over 17 months. No significant adverse events were observed, and the overall survival (OS) was more than 30 months. Conclusions Adaptive IMRT combined with high-dose brachy implantation radiotherapy and maintenance therapy can effectively improve both local control and PFS in patients with refractory recurrent metastatic esophageal cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Comprehensive treatment obtained complete remission in recurrent refractory metastatic esophageal cancer

Luo

2023

Preprint

View full text Add to dashboard Cite

Background To explore the efficacy and toxicity of multimodal radical radiotherapy and systematic therapy in refractory recurrent metastatic esophageal cancer. Patient and Methods. A 57-year-old man with locally advanced esophageal squamous cell carcinoma (ESCC) presented with supraclavicular lymph nodes and bone metastases six years after radical resection and adjuvant chemotherapy. After multiline systemic therapy, the tumor progressed with the involvement of lymph nodes in the left neck, supraclavicular, subclavian, and axillary regions, as well as the C6 vertebral bone. The patient exhibited Horner’s syndrome on the left side as well as brachial plexus nerve injury with serious pain. Adaptive intensity-modulate radiotherapy (IMRT) combined with high-dose branchy radiotherapy (BRT), and stereotactic radiotherapy (SBRT) was applied to control local foci, together with systemic treatment using target and immunotherapy as maintenance. Results The patient showed complete remission (CR) of symptoms and signs, including the complete disappearance of the left neck metastatic lymph nodes, CR of the left upper-neck metastatic lymph nodes, and satisfactory local control of bone metastases. The progression-free survival (PFS) was more than 20 months, with CR of pulmonary metastases, satisfactory control of hepatic metastases, and PFS for lung and liver foci of over 17 months. No significant adverse events were observed, and the overall survival (OS) was more than 30 months. Conclusions Adaptive IMRT combined with high-dose branchy implantation radiotherapy and maintenance therapy can effectively improve both local control and PFS in patients with refractory recurrent metastatic esophageal cancer.

show abstract

Chemoradiotherapy Versus Chemotherapy Alone for Advanced Esophageal Squamous Cell Carcinoma: The Role of Definitive Radiotherapy for Primary Tumor in the Metastatic Setting

Cited by 12 publications

References 36 publications

Effects of different treatments on the prognosis of patients with single-organ oligometastasis of oesophageal cancer after surgery--a retrospective cohort study

Effects of different treatments on the prognosis of patients with single-organ oligometastasis of oesophageal cancer after surgery--a retrospective cohort study

Multimodal radiotherapy in recurrent refractory metastatic esophageal cancer

Comprehensive treatment obtained complete remission in recurrent refractory metastatic esophageal cancer

Contact Info

Product

Resources

About